PCI术后冠心病二级预防在社区医院与三甲医院随访效果对比研究  

作　　者：郑士玉 孙凤[1] 张琦[1] 马鸿雁[1] 

机构地区：[1]北华大学附属医院,吉林132011

出　　处：《当代医学》2016年第15期4-6,共3页Contemporary Medicine

基　　金：冠心病医疗质量改善和研究(China PEACE I)(2013 BAI 09 B 00)(基金部分支持)

摘　　要：目的对经皮冠脉介入治疗(PCI)术后患者进行随访,以规范PCI术后冠心病二级预防。方法随访行PCI治疗患者360例,根据患者术后自愿选取随访定点医院的原则,分为2组,第1组160例PCI术后定期在社区医院随访,第2组200例PCI术后定期在本院心内科随访中心复查。随访指标包括冠心病危险因素控制、冠心病二级预防用药及MACE事件。结果 2组患者术后1年体重指数(BMI指数)、收缩压、空腹血糖、血脂水平与术前比较有下降,差异有统计学意义(P<0.05);焦虑抑郁评分低于PCI住院期间(P<0.05)。三甲医院随访组低密度脂蛋白胆固醇(LDL)控制水平优于社区随访组(P<0.05)。术后1年社区随访组焦虑抑郁评分下降幅度高于三甲医院随访组(P<0.05)。冠心病二级预防服药:抗血小板制剂、β受体阻滞剂的应用2组之间比较差异无统计学意义,他汀类及ACEI或ARB在社区随访组服用比例低于三甲医院随访组(P<0.05)。2组MACE事件发生率比较差异无统计学意义。结论 PCI术后规范的冠心病二级预防能有效控制冠心病危险因素,改善患者远期预后。Objective To compare the effect of secondary prevention in community hospital and secondary prevention in third-grade class-A hospital of coronary heart disease(CHD) with 15-month outcome in patients undergoing PCI, for standard the secondary prevention of CHD. MethodsA total of 360 patients undergoing PCI were investigated, devided into community hospital follow-up group third-grade class-A hospital follow-up group, after 1 year of PCI, follow- up the risk factors of CHD, compliance to secondary prevention for CHD, and MACE. Results Compare to hospitalization, there are significant difference in the BMI, SBP, fasting plasma glucose, blood lipids, and the ratio of smoke in the two groups(P<0.05), there are significant difference in depression scores and anxiety scores. The descender of depression scores and anxiety scores were higher compare the community hospital follow-up group with third-grade class-A hospital follow-up group(P<0.05). The prescription of rates of antiplatelet therapy and β-blocker were similar in the two groups. The prescription of rates of statins, angiotension conventing enzyme inhibitor(ACEI) or angiotensin receptor blocker ARB in the community hospital follow-up group were lower than the third- grade class-A hospital follow-up group(P<0.05). The MACE were similar in the two groups after 1 year of PCI. Conclusion The standardized secondary prevention of CHD after PCI can control the risk factors for CHD effectively.

关 键 词：PCI 冠心病 二级预防 社区医院随访 三甲医院随访 

分 类 号：R541.4[医药卫生—心血管疾病]